| NPI | 1104454909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 320882) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0105001) |
| 207P00000X Emergency Medicine (Licence: DC MD600004354) | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2026-08-14 |