| NPI | 1114951662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0051398) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D51398) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-07-22 |