| NPI | 1801891387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-14204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KS 0430692) |
| 207P00000X Emergency Medicine (Licence: AR E-14204) | |
| 207P00000X Emergency Medicine (Licence: MO 2014009219) | |
| 207Q00000X Family Medicine (Licence: KS 0430692) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2023-03-07 |