| NPI | 1669867883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 296590) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: NY 296590) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2025-11-19 |