| NPI | 1841233475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 16013) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 293334) |
| 207Q00000X Family Medicine (Licence: NY 293334) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2018-04-05 |