| NPI | 1215139258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 14194) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C7-0003761) |
| 207R00000X Internal Medicine (Licence: DE C7-0003761) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2012-06-22 |