| NPI | 1437140811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A72245) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-11626) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2021-11-03 |