| NPI | 1295022473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 258429) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NH 19185) |
| 207R00000X Internal Medicine (Licence: MA 258429) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2018-11-26 |