| NPI | 1790218261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD214908) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 309155) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-07-12 |