| NPI | 1174889141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101264321) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 286789) |
| 207P00000X Emergency Medicine (Licence: VA 0101264321) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-03-31 |