| NPI | 1548239015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 4450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MT4450) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2010-06-28 |