| NPI | 1831536333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AL MD.34536) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 24118) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2018-08-24 |