| NPI | 1427133537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 001880) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 249402) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2023-05-09 |