| NPI | 1013957844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 39989) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 16791) |
| 207Q00000X Family Medicine (Licence: SC 16791) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-07-25 |