| NPI | 1437352523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 29291) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.29291) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2021-03-31 |