| NPI | 1528053147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 00020559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 20559) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2008-06-27 |