| NPI | 1932126489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101-039671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101039671) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-06-08 |