| NPI | 1275221327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A23187) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS-3013) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2026-08-13 |