| NPI | 1457397101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 026594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 026594) |
| 207R00000X Internal Medicine (Licence: GA 026594) | |
| 208VP0000X (Licence: GA 026594) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-12-28 |