| NPI | 1386756971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36644) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS008731L) |
| 207Q00000X Family Medicine (Licence: PA OS008731L) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-10-26 |