| NPI | 1528292471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A149450) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NM MD2022-1046) |
| 207P00000X Emergency Medicine (Licence: TN 51688) | |
| 207R00000X Internal Medicine (Licence: LA MD.205104) | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2022-09-22 |