| NPI | 1477296531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS22747) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 334609-01) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2026-08-21 |