| NPI | 1255834065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 321378-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA T291631) |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2024-07-29 |