| NPI | 1174594329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 273986) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01054421A) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-04-28 |