| NPI | 1114906468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0085124) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 100452) |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2023-05-03 |