| NPI | 1558992933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NE 34276) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 34276) |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2024-01-11 |