| NPI | 1447211107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 144632-1) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 144632-1) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 144632-1) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2008-04-10 |