| NPI | 1609923259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VT 042.0011549) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 242399) |
| 207P00000X Emergency Medicine (Licence: VT 042-0011549) | |
| 207R00000X Internal Medicine (Licence: VT 042.0011549) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2024-01-06 |