| NPI | 1013216571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 262276) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 262276) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2015-11-05 |