| NPI | 1275533176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 37688-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 37688) |
| 207P00000X Emergency Medicine (Licence: ME MD23757) | |
| 207Q00000X Family Medicine (Licence: WI 37688-20) | |
| 207Q00000X Family Medicine (Licence: WI 37688-020) | |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2020-11-24 |