| NPI | 1841390341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 223802-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 223802) |
| 207Q00000X Family Medicine (Licence: WI 2039) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-10-17 |