| NPI | 1225142110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 206002) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 218547) |
| 207P00000X Emergency Medicine (Licence: MD D0056201) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-12-15 |