| NPI | 1457443467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-1864) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD-1864) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2010-11-04 |