| NPI | 1073540712 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H0099447)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS8230)  | 
| 207R00000X Internal Medicine (Licence: FL OS8320)  | |
| Enumeration Date | 2006-06-27 | 
| Last Update Date | 2024-03-12 |