| NPI | 1700806460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200601008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 274209) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-06-21 |