NPI | 1669472072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0047891) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0047891) |
207P00000X Emergency Medicine (Licence: VA 0101058203) | |
207R00000X Internal Medicine (Licence: DC MD046246) | |
Enumeration Date | 2005-07-28 |
Last Update Date | 2019-01-22 |