| NPI | 1063481349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 29186) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX M5575) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2018-12-10 |