| NPI | 1023122116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2012-0390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 25397) |
| 207P00000X Emergency Medicine (Licence: NY 242863) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-11-29 |