| NPI | 1245647205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2385) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO2385) |
| 207Q00000X Family Medicine (Licence: FL OS13816) | |
| 207R00000X Internal Medicine (Licence: FL 403997) | |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2019-03-12 |