| NPI | 1255794236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 322546) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 277931) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-04-19 |