| NPI | 1356345383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 007862) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 1674) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2023-03-24 |