| NPI | 1396734794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 137275) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 137275-1) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: NY NY137275) | |
| 208D00000X General Practice (Licence: NY NY137275) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2022-07-21 |