| NPI | 1821124025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME 018542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 018542) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2011-05-10 |