| NPI | 1699079202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME106903) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME106903) |
| Enumeration Date | 2010-12-23 |
| Last Update Date | 2026-07-12 |