| NPI | 1457881260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 84597) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102205367) |
| 207P00000X Emergency Medicine (Licence: GA 84597) | |
| 207R00000X Internal Medicine (Licence: VA 0116030650) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2020-04-02 |