| NPI | 1053340489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 188464) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 188464) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2008-05-23 |