| NPI | 1417268186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 4178) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.32855) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2018-12-12 |