| NPI | 1972568061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 58733) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 058733) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 058733) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2011-11-03 |