| NPI | 1912940446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 171826) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 1718263) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2014-08-21 |