| NPI | 1083680953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 93-00797) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9300797) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-11-02 |