| NPI | 1457046302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-19058) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-19058) |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2025-07-14 |