| NPI | 1689961377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: GA 76604) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME125198) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2019-10-02 |