| NPI | 1659464949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101260820) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 9500591) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-12-12 |