| NPI | 1174624357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MA 226878) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 226878) |
| 207R00000X Internal Medicine (Licence: MA 226878) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-04-07 |