| NPI | 1790244549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 321190) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA D478194) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-09-21 |