| NPI | 1144215781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: MO R5D26) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO R5D26) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2022-08-10 |