| NPI | 1730386707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01063995A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 3040) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2018-11-16 |