| NPI | 1932185188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 106077) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0526848) |
| 207Q00000X Family Medicine (Licence: MO 106077) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2016-02-12 |