| NPI | 1821033671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.28465) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.28465) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2013-08-23 |