| NPI | 1528030145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CT 032268) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 32268) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2014-10-20 |