| NPI | 1568082626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 325538) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 80323) |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2025-03-06 |