| NPI | 1730348392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0102203182) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OT011449) |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2022-08-26 |