| NPI | 1124075577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NY 148760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 148760) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2011-12-30 |