| NPI | 1659549830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C175464) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01081276A) |
| 207Q00000X Family Medicine (Licence: IL 036126793) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2026-02-27 |