| NPI | 1386038750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PR 34027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10052386) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2018-08-11 |