| NPI | 1902866809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 161006) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 161006) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2009-06-30 |