| NPI | 1699756973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 13367) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.13367) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2022-01-12 |