| NPI | 1265922983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.143986) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 322939) |
| 207Q00000X Family Medicine (Licence: NY P10277) | |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2023-07-07 |