| NPI | 1538137518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL me50679) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME0050679) |
| 207R00000X Internal Medicine (Licence: FL me50679) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2016-09-15 |