| NPI | 1851579304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 146083) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME67656) |
| 207R00000X Internal Medicine (Licence: FL ME67656) | |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2019-02-08 |