| NPI | 1407961980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 28264) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 28264) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2011-11-16 |