| NPI | 1205878386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 026664) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 026664) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-07-24 |