| NPI | 1376638460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01045636A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 32515) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-03-07 |