| NPI | 1033476718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD041094) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 264970) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2013-08-12 |