| NPI | 1548764962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 150765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 310205) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-09-25 |