| NPI | 1154314722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 73510) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01041443A) |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2023-09-08 |