| NPI | 1003279456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 29862) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10897300) |
| 207P00000X Emergency Medicine (Licence: NY 304201) | |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2022-04-20 |