| NPI | 1710183751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 335574-01) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS025251) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2026-06-29 |