| NPI | 1396242574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 312304) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A184421) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2023-06-27 |