| NPI | 1932120755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VT 042-0008574) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: VT 0420008574) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-10-29 |