| NPI | 1326312604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 13717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 07406) |
| 207R00000X Internal Medicine (Licence: MS 07406) | |
| 207P00000X Emergency Medicine (Licence: TN 07406) | |
| Enumeration Date | 2012-03-03 |
| Last Update Date | 2012-03-13 |