| NPI | 1639120314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD28549) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA MD.018258) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2021-03-22 |