| NPI | 1285629162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 224511) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA07883600) |
| 207P00000X Emergency Medicine (Licence: TX T2314) | |
| 207P00000X Emergency Medicine (Licence: PA MD467343) | |
| 207P00000X Emergency Medicine (Licence: PA 0101243644) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2025-02-25 |