| NPI | 1063919686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL 168468) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 309562) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2024-07-02 |