| NPI | 1316443963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME163238) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 307465) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-02-26 |