| NPI | 1477507713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 23848) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2006-00448) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2024-04-18 |