| NPI | 1952565368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-39445) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA MD-39445) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2024-04-17 |