| NPI | 1851739023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 33688) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.33688) |
| 207R00000X Internal Medicine (Licence: GA 72744) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2024-04-08 |