| NPI | 1033748553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102208469) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 4073) |
| 207P00000X Emergency Medicine (Licence: NJ 3902000000X) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-07-10 |