| NPI | 1437125481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R8828) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301502858) |
| 207Q00000X Family Medicine (Licence: TN 61863) | |
| 207Q00000X Family Medicine (Licence: AR E4343) | |
| 207Q00000X Family Medicine (Licence: GA 87073) | |
| 207Q00000X Family Medicine (Licence: IN 01084709A) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-10-02 |