| NPI | 1497799944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 109643) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C41876) |
| 207R00000X Internal Medicine (Licence: CA C41876) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-02-14 |