| NPI | 1700078581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-10978) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: ID M-10978) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2022-08-11 |