| NPI | 1801455126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 321694) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 291010) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2023-10-26 |