| NPI | 1508325721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 326826) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 326826) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-01-28 |