| NPI | 1013321280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5315066708) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME131625) |
| 207P00000X Emergency Medicine (Licence: MI 4301106023) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: FL ME131625) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME131625) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-11-27 |