| NPI | 1184697203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C-8451) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C8451) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2024-06-20 |