| NPI | 1255475075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101053022) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 010153022) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2022-07-21 |