| NPI | 1982229993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI 1171933) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 1171933) |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2024-11-06 |