| NPI | 1407143936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 262355) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS15536) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2026-01-28 |