| NPI | 1427391465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL me127920) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME127920) |
| 207Q00000X Family Medicine (Licence: AR E8958) | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2020-10-27 |