| NPI | 1811171358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 242659) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0069146) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2016-01-27 |