| NPI | 1720032725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-8494) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-4932) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: ID M-4932) | |
| 207Q00000X Family Medicine (Licence: ID m8494) | |
| 207Q00000X Family Medicine (Licence: ID M-4932) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2022-02-25 |