| NPI | 1851735138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 76007) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036167656) |
| 207Q00000X Family Medicine (Licence: IL 036167656) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2026-07-01 |