| NPI | 1881989523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA 199456) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 296114) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2019-03-06 |