| NPI | 1063476752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A85778) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01058306A) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2022-04-08 |