| NPI | 1922044502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 13895) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 29610) |
| 207P00000X Emergency Medicine (Licence: MS 10491) | |
| 207R00000X Internal Medicine (Licence: MS 10491) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2011-11-14 |