| NPI | 1346391299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 059237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 059237) |
| 207Q00000X Family Medicine (Licence: FL OS10149) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2017-02-08 |