| NPI | 1427407006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 60695) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 60695) |
| 207Q00000X Family Medicine (Licence: TN 0000059755) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2023-01-04 |