| NPI | 1497175236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 308867) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 308867) |
| Enumeration Date | 2014-04-20 |
| Last Update Date | 2023-03-14 |