| NPI | 1023128493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: ID M-7514) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-7514) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-06-06 |