| NPI | 1902944226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 200110) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 200110) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2008-11-13 |