| NPI | 1306817366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 115129) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU M-1903) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-06-14 |