| NPI | 1154502276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 149101) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NY 149101) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2026-02-04 |