| NPI | 1497198402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A149593) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A149593) |
| 208000000X Pediatrics (Licence: CA A149593) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2019-07-09 |