| NPI | 1245795087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-50447) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 23327) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2024-12-18 |