| NPI | 1437262573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-5001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR T2006-117) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-11-03 |