| NPI | 1790279966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: NY 315946) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 315946) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2023-07-26 |