| NPI | 1013479807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 87610) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 87610) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-09-25 |