| NPI | 1396793733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 056900) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SC 16019) |
| 207Q00000X Family Medicine (Licence: SC 16019) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2012-08-16 |