| NPI | 1578506291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 5908503-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: UT 5908503-1205) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2019-05-15 |