| NPI | 1356780894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 3017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL35696) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2017-03-02 |