| NPI | 1841254067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200101319) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 200101319) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2013-06-24 |