| NPI | 1013357508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 291513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 291513) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2026-05-01 |