| NPI | 1417957598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101037883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101037883) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2023-03-28 |