| NPI | 1093715203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 37912) |
| Additional Taxonomies | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: TN 37912) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2011-07-20 |