| NPI | 1215953021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: LA 13186R) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 13186R) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-06-05 |