| NPI | 1205283710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 70513) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI DO01008) |
| 207R00000X Internal Medicine (Licence: RI LP03618) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-08-19 |