| NPI | 1740396753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MT 8633) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 8633) |
| 207V00000X Obstetrics & Gynecology (Licence: MT 8633) | |
| 208M00000X Hospitalist (Licence: MT 8633) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-08 |