| NPI | 1184730236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 110734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 110734) |
| 208000000X Pediatrics (Licence: MO 110734) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2022-11-10 |