| NPI | 1033185715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 24803) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 221630) |
| 207Q00000X Family Medicine (Licence: NY 221630) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2019-02-06 |