| NPI | 1144251679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MO 2003024384) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: MO 2003024384) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-08-21 |