| NPI | 1053587014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101253949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 233317) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2015-02-20 |