| NPI | 1467433623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 14560) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD30284) |
| 208000000X Pediatrics (Licence: TN MD30284) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2019-02-25 |