| NPI | 1518312487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2019017133) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 302717) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2023-01-30 |