| NPI | 1992217178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO 2017033642) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 71353-20) |
| 207Q00000X Family Medicine (Licence: IL 036157152) | |
| Enumeration Date | 2017-10-28 |
| Last Update Date | 2025-02-04 |