| NPI | 1194037200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 264029) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 147759) |
| 208D00000X General Practice (Licence: NY 264029) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2018-12-18 |