| NPI | 1073658035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 248852) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 42773) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2021-02-22 |