| NPI | 1144660622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 299249) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 269228) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2024-03-15 |