| NPI | 1174145411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME DO3854) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 321759) |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2024-08-15 |