| NPI | 1184679029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 17865) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101057267) |
| 207P00000X Emergency Medicine (Licence: VA 0101057267) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2022-04-18 |