| NPI | 1356441091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 20525) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 20525) |
| 207R00000X Internal Medicine (Licence: WI 20525) | |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2009-09-17 |