| NPI | 1124253661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD D79706) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D79706) |
| 207R00000X Internal Medicine (Licence: MD D79706) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2016-03-16 |