| NPI | 1881645349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 171698) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 171698) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2016-04-15 |