| NPI | 1710070412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 236503) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD425081) |
| 207P00000X Emergency Medicine (Licence: MI 4301511279) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2024-03-21 |