| NPI | 1023247723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 070661) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8762) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2020-10-19 |