| NPI | 1417161795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2007012442) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-6079) |
| 207Q00000X Family Medicine (Licence: MO 2007012442) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-02-12 |