| NPI | 1265471635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101045541) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 101045541) |
| 207P00000X Emergency Medicine (Licence: TN 40295) | |
| 207Q00000X Family Medicine (Licence: VA 0101045541) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2022-04-11 |