| NPI | 1346816444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-17156) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A202193) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2025-08-22 |