| NPI | 1225074586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 032915) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 177633) |
| 207R00000X Internal Medicine (Licence: CT 032915) | |
| 207R00000X Internal Medicine (Licence: NY 177633) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-07-25 |