| NPI | 1699779389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME79705) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME79705) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2009-07-09 |