| NPI | 1568796175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 266811) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA ot013044) |
| 207R00000X Internal Medicine (Licence: PA ot013044) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2014-09-18 |