| NPI | 1851330070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 11824R) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 11824R) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2019-03-19 |