| NPI | 1851550073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 81239) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A119141) |
| 207P00000X Emergency Medicine (Licence: IN 01088236A) | |
| 207P00000X Emergency Medicine (Licence: NY 246346) | |
| 207P00000X Emergency Medicine (Licence: MA 1024828) | |
| 207P00000X Emergency Medicine (Licence: PA MD491529) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2026-04-22 |