| NPI | 1700044799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 53221-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 248535) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2020-10-15 |