| NPI | 1306099676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 55355) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 55355-20) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2024-08-05 |