| NPI | 1942644570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D81373) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 282939) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2016-06-21 |