| NPI | 1255326567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 204372) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 204372-1) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2013-09-17 |