| NPI | 1326017468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME147452) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX P7465) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2023-02-23 |