| NPI | 1699787804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.30275) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036-117166) |
| 207P00000X Emergency Medicine (Licence: WV 7956) | |
| 207P00000X Emergency Medicine (Licence: FL ME107562) | |
| 207R00000X Internal Medicine (Licence: WY TL7008) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-01-14 |