| NPI | 1538147723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301051672) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: MI 4301051672) |
| 207R00000X Internal Medicine (Licence: MI 4301051672) | |
| 207RS0010X Internal Medicine, Sports Medicine (Licence: MI 4301051672) | |
| 208D00000X General Practice (Licence: MI 4301051672) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2007-10-27 |