| NPI | 1194834747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS MD 11335) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 11335) |
| 209800000X Legal Medicine (Licence: MS MD 11335) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-09-11 |