| NPI | 1255323564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 025220) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 025220) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: GA 025220) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2015-05-29 |