| NPI | 1194084152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 305422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 305422) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2020-07-15 |