| NPI | 1972122588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1014347) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301510988) |
| 207P00000X Emergency Medicine (Licence: NY 321600) | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2024-03-21 |