| NPI | 1447665732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H91064) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA Os018194) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-03-22 |