| NPI | 1285856971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR AR-E-5146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E5146) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2024-05-21 |