| NPI | 1033161872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME EL181033) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 085922) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-08-09 |