| NPI | 1477723120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 063337) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.43905) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2023-03-10 |