| NPI | 1174184931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-13356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-13356) |
| 207Q00000X Family Medicine (Licence: MO 2019022911) | |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2022-12-20 |