| NPI | 1265506778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 045234) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 045234) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MI 045234) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-09-11 |