| NPI | 1609197573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA 4225) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 4225) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2021-06-30 |