| NPI | 1851974448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 026593-01) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 26593) |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2023-07-22 |