| NPI | 1689737728 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 233549) | 
| Additional Taxonomies | 174400000X Specialist (Licence: NY 233549) | 
| Enumeration Date | 2006-12-19 | 
| Last Update Date | 2024-06-25 |