| NPI | 1538322417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 242653) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 252023) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-02-04 |