| NPI | 1417911389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101044364) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101044364) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-05-07 |