| NPI | 1437446960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD D77180) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: DC MD042056) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2022-07-21 |