| NPI | 1962896092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 298957) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 60483) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-09-20 |