| NPI | 1477908234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 16088A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0116029170) |
| 207R00000X Internal Medicine (Licence: VA 0116029170) | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2023-09-19 |