| NPI | 1679678379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-13953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-13953) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2025-06-09 |