| NPI | 1710978176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 42378) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: SD 5623) |
| 207Q00000X Family Medicine (Licence: SD 5623) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2021-11-22 |