| NPI | 1043415904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 69514-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 69514-20) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2022-09-21 |