| NPI | 1568502938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-2234) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-2234) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2019-10-31 |