| NPI | 1407057029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 244273) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244273) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2016-11-04 |