| NPI | 1750555629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-01551) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2013-01551) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2013-09-18 |