| NPI | 1942375050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301063467) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301063467) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MT 138617) | |
| 207R00000X Internal Medicine (Licence: MT 138617) | |
| 208000000X Pediatrics (Licence: MT 138617) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2024-10-21 |