| NPI | 1316909369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 02232) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 42188) |
| 207R00000X Internal Medicine (Licence: IA 02232) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2016-08-19 |