| NPI | 1013010081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 9398) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009009697) |
| 207Q00000X Family Medicine (Licence: MO T2006016520) | |
| 207P00000X Emergency Medicine (Licence: MO 2009009697) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2022-03-21 |