| NPI | 1588659924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01057350A) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01057350A) |
| 207P00000X Emergency Medicine (Licence: IN 01057350A) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2011-10-06 |