| NPI | 1740625656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 283614) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 17439) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2017-11-03 |