| NPI | 1891020384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 264676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA 195440) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2022-07-21 |