| NPI | 1821386632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0011011) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DE C1-0011011) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2023-06-13 |