| NPI | 1053725499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-11695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-11695) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301104828) | |
| 208D00000X General Practice (Licence: GA 074885) | |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2019-07-23 |