| NPI | 1588655757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 037878) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 037878) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2011-04-19 |