| NPI | 1033383096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 53498) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 065720) |
| 207P00000X Emergency Medicine (Licence: TN 49506) | |
| 207P00000X Emergency Medicine (Licence: FL ME107057) | |
| 207P00000X Emergency Medicine (Licence: KY 53498) | |
| 207Q00000X Family Medicine (Licence: TN 49506) | |
| 207Q00000X Family Medicine (Licence: FL ME107057) | |
| 207Q00000X Family Medicine (Licence: GA 065720) | |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2022-02-03 |