| NPI | 1235254186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 57800) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 57800) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2012-11-05 |