| NPI | 1881851491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.30834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.30834) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2019-09-17 |