| NPI | 1730190265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 195623-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 195623-1) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2016-10-31 |