| NPI | 1942594817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 302149) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MT#199043) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2020-03-25 |