| NPI | 1316479843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 322238) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD203813) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-07-05 |