| NPI | 1871537548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 027774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 162917-1) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2015-09-19 |