| NPI | 1326134768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 0420009083) |
| Additional Taxonomies | 207PE0004X Emergency Medicine Emergency Medical Services (Licence: VT 042-0009083) |
| 207R00000X Internal Medicine (Licence: VT 042.0009083) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2024-02-21 |