| NPI | 1235499856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.208136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.208136) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2017-10-11 |