| NPI | 1679542781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 041178) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 41178) |
| 207P00000X Emergency Medicine (Licence: FL ME58453) | |
| 207P00000X Emergency Medicine (Licence: NY 1870621) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2010-06-21 |