| NPI | 1669987335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 2730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS T-3496) |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2024-04-10 |