| NPI | 1376935197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 314641-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD21391) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2026-07-20 |