| NPI | 1487004230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 82620) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301110110) |
| 207Q00000X Family Medicine (Licence: GA 82620) | |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2025-06-11 |