| NPI | 1275624470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 66206) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 241913) |
| 207Q00000X Family Medicine (Licence: NY 241913) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-09-08 |