| NPI | 1770773517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD MD14442) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD MD14442) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD MD 14442) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |