| NPI | 1245465384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 80035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 265544) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2025-06-10 |