| NPI | 1972730380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ME MD24366) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101250100) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2024-04-25 |