| NPI | 1659692374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 2702441) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 2702441) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2025-08-22 |