| NPI | 1427408038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-12191) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC Ll39642) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2020-10-12 |