| NPI | 1205222528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 292598) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2021-01843) |
| 207P00000X Emergency Medicine (Licence: CA C201031) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA10676100) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2026-05-18 |