| NPI | 1417148974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA DO.000185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 56690) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2012-12-05 |