| NPI | 1629090790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO.1443) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL OS9816) |
| 207Q00000X Family Medicine (Licence: FL OS9816) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-03-27 |