| NPI | 1912954033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO R2E39) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R2E39) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MO R2E39) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2015-05-01 |