| NPI | 1437679651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-13273) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018023700) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-09-13 |