| NPI | 1720176704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 45257) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 045257) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-03-04 |