| NPI | 1104119403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SD 10182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 27102) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2022-03-24 |