| NPI | 1013590231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 336753) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT020700) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2025-07-29 |