| NPI | 1114488566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1015471) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 320016) |
| 207P00000X Emergency Medicine (Licence: MI 5101027882) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-03-21 |