| NPI | 1902484017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO.3055) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AL DO.3055) |
| 207Q00000X Family Medicine (Licence: MS 33419) | |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2026-03-23 |