| NPI | 1720344583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.33094) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 24578) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2022-05-02 |