| NPI | 1629151550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 36435) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 16053) |
| 207R00000X Internal Medicine (Licence: SC 16053) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-07-14 |