| NPI | 1841297223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 162486) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 162486) |
| 207P00000X Emergency Medicine (Licence: NJ 25MA06750300) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2014-02-10 |