| NPI | 1013271485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-12132) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-12132) |
| 207Q00000X Family Medicine (Licence: TN 48437) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2019-10-14 |