| NPI | 1093861890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 9894) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ME DO3702) |
| 207Q00000X Family Medicine (Licence: NH 9894) | |
| 207P00000X Emergency Medicine (Licence: NY 183910) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-12-01 |