| NPI | 1366146995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS025942) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 343096) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2026-09-25 |