| NPI | 1043447758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 241057) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 265683) |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2025-03-13 |