| NPI | 1407866171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 238125) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 194655) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2026-05-19 |