| NPI | 1154857944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 304147) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10943600) |
| 207P00000X Emergency Medicine (Licence: KY 57651) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-05-30 |