| NPI | 1285685719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-17444) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME76192) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2024-11-05 |