| NPI | 1437195682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0069796) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 219037) |
| 207P00000X Emergency Medicine (Licence: AZ 35962) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-06-02 |