| NPI | 1013202225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 279400-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 258160) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2025-08-05 |