| NPI | 1861470247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 298295) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0014311) |
| 207P00000X Emergency Medicine (Licence: CO 35127) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2025-12-08 |