| NPI | 1598939340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME-124249) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 253622) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2024-06-27 |