| NPI | 1851592133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 302334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101015964) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-10-19 |