NPI | 1215912829 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME78717) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 12402) |
207R00000X Internal Medicine (Licence: FL ME78717) | |
207R00000X Internal Medicine (Licence: PR 12402) | |
Enumeration Date | 2005-12-07 |
Last Update Date | 2024-08-14 |