| NPI | 1669635124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MA 253944) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MA 253944) |
| Enumeration Date | 2008-07-05 |
| Last Update Date | 2014-06-06 |