| NPI | 1083798763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX J3249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX J3249) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX J3249) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2009-12-03 |