| NPI | 1730455767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 282011-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD P28056) |
| 207P00000X Emergency Medicine (Licence: MD D0080519) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2016-10-13 |