| NPI | 1427151737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200400717) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 230455) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2026-04-23 |