| NPI | 1598054934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C167901) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01073814A) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2022-08-18 |