| NPI | 1588602189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 042336) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 42336) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2010-08-04 |