| NPI | 1962438739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS10692) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS012606) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2015-04-22 |