| NPI | 1689714578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9500462) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 212899-1) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-08-02 |