| NPI | 1649632357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 301701) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A154840) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-12-01 |