| NPI | 1720571102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AR E-16131) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR e-16131) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2025-01-09 |