| NPI | 1669482386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 33055) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 33055) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 33055) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2022-06-15 |