| NPI | 1528062585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0116027596) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102204762) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2023-06-26 |