| NPI | 1518347939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI DOS-2279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 076976) |
| 208D00000X General Practice (Licence: GA 076976) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2022-12-19 |