| NPI | 1750672101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: NY 289152) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 289152) |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2023-08-28 |