| NPI | 1891077210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101252506) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 262231) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2020-06-11 |