| NPI | 1609921212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 9900744) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9900744) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2009-05-19 |