| NPI | 1396711602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 58772) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 58772) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2008-05-07 |