| NPI | 1386774388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD202418) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2011008025) |
| 207P00000X Emergency Medicine (Licence: IL 036147913) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2024-09-26 |