| NPI | 1831178524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-0957) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-0957) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2014-04-08 |