| NPI | 1467912402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 73698) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.44669) |
| 207P00000X Emergency Medicine (Licence: MN 73698) | |
| 207Q00000X Family Medicine (Licence: AL MD.44669) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2025-01-06 |