| NPI | 1912938408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD22010) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101054698) |
| 207P00000X Emergency Medicine (Licence: MD D0051128) | |
| 207P00000X Emergency Medicine (Licence: DC MD22010) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-08-18 |