| NPI | 1184170185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM MD2019-0238) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2016-0467) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2020-06-24 |