| NPI | 1134278468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 31543) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 31543) |
| 207P00000X Emergency Medicine (Licence: WI 29355) | |
| 207R00000X Internal Medicine (Licence: WI 29355) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2019-08-28 |