| NPI | 1972246304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 346190) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A203879) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2026-08-25 |