| NPI | 1427038082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C-7660) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C7660) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2010-08-13 |