| NPI | 1417128208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 32229) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 32229) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2023-05-03 |