| NPI | 1851705453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 294700) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021082) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2022-08-18 |