| NPI | 1124069240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.14926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL 00014926) |
| 208VP0000X (Licence: AL 14926) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-06-23 |