| NPI | 1376613323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A146008) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 15189) |
| 207P00000X Emergency Medicine (Licence: CA 20A8342) | |
| 207P00000X Emergency Medicine (Licence: FL OS7227) | |
| 207Q00000X Family Medicine (Licence: CA 20A8342) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-03-31 |