| NPI | 1649667957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 290986) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS019157) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2024-08-16 |