| NPI | 1922374834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 296065) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2015-0646) |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2019-02-13 |