| NPI | 1083689855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-2332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E2332) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2016-01-19 |