| NPI | 1235301318 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 265759)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME148415)  | 
| Enumeration Date | 2008-03-28 | 
| Last Update Date | 2024-09-27 |