| NPI | 1679529812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 217029) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD443368) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-03-26 |