| NPI | 1619503653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 321573) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 74965) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2023-07-18 |