| NPI | 1578051124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 1014630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1014630) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2023-09-07 |