| NPI | 1922494392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A169634) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 298849) |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2024-04-18 |