| NPI | 1063430239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 176211) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 176211) |
| 207R00000X Internal Medicine (Licence: NY 176211) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-07-03 |