| NPI | 1659571438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL 1066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 002478) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2026-06-18 |