| NPI | 1740249853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 200001617) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2000-01617) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2007-10-12 |