| NPI | 1427478056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: AZ 011074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 011074) |
| 207R00000X Internal Medicine (Licence: NY 293482-01) | |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: NY 293482-01) | |
| 208000000X Pediatrics (Licence: AZ 011074) | |
| 208000000X Pediatrics (Licence: NY 293482-01) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2024-08-14 |