| NPI | 1437228541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GU M001272) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GU M-1272) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-07-26 |