| NPI | 1952578858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: DE C7-0004017) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0009486) |
| 207R00000X Internal Medicine (Licence: DE C1-0009486) | |
| Enumeration Date | 2008-05-11 |
| Last Update Date | 2013-05-24 |