| NPI | 1801392659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 88613) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 307937) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-11-22 |