| NPI | 1669857447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME159769) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 294694) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2023-06-09 |