| NPI | 1194898981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 153110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 153110) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2012-03-05 |