| NPI | 1679550446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0052735) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0052735) |
| 207P00000X Emergency Medicine (Licence: VA 101256598) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-03-03 |