| NPI | 1588801559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 250425) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 250425) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2009-08-21 |