| NPI | 1932237955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 15954) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00015954) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2021-02-23 |