| NPI | 1871020420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 305616) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: FL ME155860) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2025-11-05 |