| NPI | 1982921466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 285630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 270153-1) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2020-12-15 |