| NPI | 1124605605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 343813) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 343813) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2026-07-27 |