| NPI | 1295894442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR C-7164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 07428R) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-03-07 |