| NPI | 1740289206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO R9A57) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO R957) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-09-14 |