| NPI | 1700938297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 352047) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 164300) |
| 207R00000X Internal Medicine (Licence: CA 352047) | |
| 207R00000X Internal Medicine (Licence: NY 164300) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2022-08-10 |