| NPI | 1447214267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 14866) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 14866) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2023-02-16 |