| NPI | 1013364660 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL 164280) | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 295390) | 
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: FL 164280) | |
| Enumeration Date | 2016-05-24 | 
| Last Update Date | 2023-12-20 |