| NPI | 1528059219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 2109421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD208521) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2023-07-26 |