| NPI | 1700048238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 2012038833) |
| Additional Taxonomies | 207RC0200X Internal Medicine Critical Care Medicine (Licence: MO 2012038833) |
| 208D00000X General Practice (Licence: MO 2012038833) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2025-07-18 |