| NPI | 1578023206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1023629) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 316669) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2026-09-17 |