| NPI | 1821018805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 09264R) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 09264R) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-10-02 |