| NPI | 1427686757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301507204) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301507204) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-05-19 |