| NPI | 1588795546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 5101016798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101016798) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2013-01-22 |