| NPI | 1154438349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D65991) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D65991) |
| 207P00000X Emergency Medicine (Licence: DE C7-0002982) | |
| 207P00000X Emergency Medicine (Licence: DE C10008032) | |
| 207P00000X Emergency Medicine (Licence: MD D65991) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2026-06-01 |