| NPI | 1740450220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101243430) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 248590) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2021-04-14 |