| NPI | 1902366149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD28830) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 318199) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-02-07 |