| NPI | 1629163621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.090007) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 237813) |
| 207R00000X Internal Medicine (Licence: NY 237813) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-05-22 |