| NPI | 1245255819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 41414) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 54045) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-11-02 |