| NPI | 1225440209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD21687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD468812) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2020-03-09 |