| NPI | 1427498799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD044450) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116026349) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2023-09-28 |