| NPI | 1033402276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD27300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD14495) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2023-07-17 |