| NPI | 1689725343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 169284) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 169284) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-01-20 |