| NPI | 1982692596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 215357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 232041) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2023-05-31 |