| NPI | 1699261446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 326281) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102206717) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2024-04-19 |