| NPI | 1902917834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M-12814) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 103780) |
| 207R00000X Internal Medicine (Licence: MO 103780) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-07-21 |