NPI | 1114995354 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101250560) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-094065) |
207P00000X Emergency Medicine (Licence: OH 35.099885) | |
207P00000X Emergency Medicine (Licence: WA MD00021559) | |
207R00000X Internal Medicine (Licence: TN 47911) | |
Enumeration Date | 2006-03-14 |
Last Update Date | 2016-03-31 |