| NPI | 1861519969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI 5914) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: HI 5914) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2013-04-10 |