| NPI | 1932311305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 285883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD437932) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA08771900) | |
| 207P00000X Emergency Medicine (Licence: DC MD041706) | |
| 207P00000X Emergency Medicine (Licence: CT 053630) | |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2025-06-23 |