| NPI | 1174728737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 250806) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-232489) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2014-06-23 |