| NPI | 1982800991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 65616-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 65616-20) |
| 207P00000X Emergency Medicine (Licence: MI 4301089947) | |
| 207P00000X Emergency Medicine (Licence: IA 41049) | |
| 207R00000X Internal Medicine (Licence: IA 41049) | |
| 207R00000X Internal Medicine (Licence: MI 4301089947) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IA 41049) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2022-07-18 |