| NPI | 1730116583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101235176) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101235176) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2022-01-25 |