| NPI | 1871528430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 239481) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 239481) |
| 207P00000X Emergency Medicine (Licence: NY 239481) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-04-29 |