| NPI | 1467462150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 28299) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD28299) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2015-05-27 |