| NPI | 1821365594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 269650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 269650) |
| Enumeration Date | 2011-11-24 |
| Last Update Date | 2013-04-26 |