| NPI | 1275596827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 35198) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 35198) |
| 207Q00000X Family Medicine (Licence: AZ 35198) | |
| 207R00000X Internal Medicine (Licence: AZ 35198) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2016-01-12 |