| NPI | 1396006995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 305215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 305215) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2017-07-25 |