| NPI | 1720378342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 276690-1) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: NY 276690) |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2024-01-25 |