| NPI | 1154764751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD182210) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 284677) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2025-01-23 |