| NPI | 1245204031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL MD22834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 22834) |
| 207P00000X Emergency Medicine (Licence: FL ME90738) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2020-12-04 |