| NPI | 1952836124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 303281) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 064930) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2020-08-19 |