| NPI | 1720303035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2020-0358) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 251375) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2024-02-16 |