| NPI | 1376003491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 327626) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101274694) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2024-05-07 |