| NPI | 1952615973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.31478) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 31478) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2014-07-22 |