NPI | 1417148891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101259467) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 76158) |
207P00000X Emergency Medicine (Licence: KY 44451) | |
207P00000X Emergency Medicine (Licence: TX U6186) | |
207QA0505X Family Medicine, Adult Medicine (Licence: IL 036126164) | |
Enumeration Date | 2007-08-09 |
Last Update Date | 2025-06-18 |