| NPI | 1871609321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 253190-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD H79258) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2026-01-09 |