| NPI | 1407242373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CT 70723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 147618) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2022-07-19 |