| NPI | 1053688952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 66361) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101020852) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MI 5101020852) | |
| Enumeration Date | 2011-11-20 |
| Last Update Date | 2020-01-24 |