| NPI | 1598029548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 074536) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 5486) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2015-07-13 |