| NPI | 1598737207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 9500405) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 9500405) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-12-08 |