| NPI | 1689777054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D76823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D76823) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2015-11-23 |