| NPI | 1194187435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MA 1015407) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1015407) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2023-08-08 |