| NPI | 1841426319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 032-0134126) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 322420) |
| 207P00000X Emergency Medicine (Licence: NY 00243361) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2023-08-08 |