| NPI | 1548846140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 334926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101281857) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2026-03-06 |