| NPI | 1790087401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-48492) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-48492) |
| 207P00000X Emergency Medicine (Licence: PA MT198217) | |
| 207R00000X Internal Medicine (Licence: PA MT198217) | |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2021-06-17 |