| NPI | 1679585194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 150939) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 150939) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2012-07-11 |