| NPI | 1154177459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: PR 1965PA) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 1965) |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-04-26 |