| NPI | 1245260140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C-4860) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AR C4860) |
| 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: AR C4860) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2022-12-14 |