| NPI | 1437348950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 54349) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 54349) |
| 207Q00000X Family Medicine (Licence: AL 29845) | |
| Enumeration Date | 2007-10-21 |
| Last Update Date | 2023-10-27 |