| NPI | 1841434404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA MD.206408) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 051743) |
| 207Q00000X Family Medicine (Licence: CA A123745) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2025-09-18 |