| NPI | 1538221999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 338779) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC LL88205) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2025-07-25 |