| NPI | 1639220270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS MS12439) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM MD2020-0910) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MS 12439) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: AL 15095) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2021-07-12 |