| NPI | 1497767248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD034806) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0061159) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2012-05-04 |