| NPI | 1093743379 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NH 9805) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VT 042.0009245) | 
| Enumeration Date | 2006-06-28 | 
| Last Update Date | 2024-01-08 |