NPI | 1104872019 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101045615) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2014-02252) |
Enumeration Date | 2006-05-25 |
Last Update Date | 2015-10-15 |