| NPI | 1891713293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME57929) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0057929) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-03-10 |