| NPI | 1346227311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 218692) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 218692) |
| 207P00000X Emergency Medicine (Licence: NY 218692) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2023-07-05 |