| NPI | 1679547301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-2094) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E2094) |
| 207R00000X Internal Medicine (Licence: AR E2094) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-01-05 |