| NPI | 1841677150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101265998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 288896) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2023-10-11 |