| NPI | 1598108557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS14434) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2014036373) |
| 207P00000X Emergency Medicine (Licence: FL OS14434) | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2024-11-13 |