| NPI | 1437470051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 50532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.3277) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2013-10-04 |