| NPI | 1417516998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS025827) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 319178-01) |
| 207P00000X Emergency Medicine (Licence: NY 319178) | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2026-07-14 |