| NPI | 1386179364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 332668) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 20187) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2024-11-25 |