| NPI | 1003830555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO1644) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 4284) |
| 207P00000X Emergency Medicine (Licence: NV DO1644) | |
| 207P00000X Emergency Medicine (Licence: AZ 4284) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2024-07-17 |