| NPI | 1669979571 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0102208434)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0102208434)  | 
| Enumeration Date | 2018-04-07 | 
| Last Update Date | 2024-06-17 |