| NPI | 1265533947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 22664) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 22664) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2019-10-15 |