| NPI | 1740227313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A81939) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.127531) |
| 207P00000X Emergency Medicine (Licence: NY 320021) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-04-28 |