| NPI | 1265580575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 54280) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 146677) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MA 54280) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 146677) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-07-08 |