| NPI | 1316993462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200401293) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2004-01293) |
| 207R00000X Internal Medicine (Licence: SC 31254) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-09-14 |