| NPI | 1518166222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: CA A117650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 261567) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2015-10-06 |