| NPI | 1972661726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO1371) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 35224-021) |
| 207Q00000X Family Medicine (Licence: NV DO1371) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2022-12-21 |