| NPI | 1750327391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2021-02358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C6471) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: AR C-6471) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AR C-6471) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2022-03-16 |