| NPI | 1427067867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E4686) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR E4686) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-07-18 |