| NPI | 1992906143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-7951) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-7951) |
| 207P00000X Emergency Medicine (Licence: VA 0101245862) | |
| 207P00000X Emergency Medicine (Licence: NC 2009-01263) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2021-07-29 |