| NPI | 1427038678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-6585) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-6585) |
| 207Q00000X Family Medicine (Licence: VA 0102201763) | |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2017-07-18 |