| NPI | 1932323250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME32265) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME32265) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2013-05-31 |