| NPI | 1629169867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: SC 39950) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: SC 39950) |
| 207R00000X Internal Medicine (Licence: SC 39950) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 39950) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-11-04 |