| NPI | 1881058170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME172462) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 302988) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2025-06-03 |