| NPI | 1467436725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-4782) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AR E4782) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2024-02-14 |