| NPI | 1235195785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-7237) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME137708) |
| 207P00000X Emergency Medicine (Licence: MO 2011003498) | |
| 208D00000X General Practice (Licence: VA 0101236812) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-11-25 |