| NPI | 1609866573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0062257) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01053945A) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2019-07-24 |