| NPI | 1649292079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 30355) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 043175) |
| 207P00000X Emergency Medicine (Licence: SC 30355) | |
| 207R00000X Internal Medicine (Licence: GA 043175) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2012-03-28 |