| NPI | 1588622732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 33718) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-A28-TA-593) |
| 207P00000X Emergency Medicine (Licence: TN 50983) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-11-02 |