| NPI | 1982829941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 258164-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD12946) |
| 207P00000X Emergency Medicine (Licence: CA A113070) | |
| 207P00000X Emergency Medicine (Licence: OH 35.127265) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2024-01-15 |