| NPI | 1104937101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 034516) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 034516) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-11 |