| NPI | 1720054661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 047292) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 19457) |
| 207P00000X Emergency Medicine (Licence: NY 233384) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2019-03-07 |