| NPI | 1477571453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD 27384) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MS 17333) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-12-14 |