| NPI | 1649912759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-16897) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-16897) |
| Enumeration Date | 2022-04-09 |
| Last Update Date | 2024-12-18 |