| NPI | 1861585010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 1322) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101015482) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2014-10-15 |