| NPI | 1386670891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.020886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA L020886) |
| 207P00000X Emergency Medicine (Licence: LA L020886) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2018-08-28 |