| NPI | 1710949987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD13760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD13760) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2012-02-06 |