| NPI | 1720068976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-10029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G077257) |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2023-12-06 |