| NPI | 1437262003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C5735) | 
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR C5735) | 
| Enumeration Date | 2006-08-16 | 
| Last Update Date | 2020-09-28 |