| NPI | 1346559630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 257977) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 258871) |
| 207R00000X Internal Medicine (Licence: MA 257977) | |
| 207R00000X Internal Medicine (Licence: NY 258871) | |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2021-11-18 |