| NPI | 1275095457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-20029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 67565) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2026-01-03 |