| NPI | 1427477447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 270249) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 270249) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2025-04-01 |