| NPI | 1144232349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A65782) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A65782) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2015-12-31 |