| NPI | 1669467288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 23379) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00023379) |
| 207P00000X Emergency Medicine (Licence: AL 23379) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2014-10-14 |