| NPI | 1801837141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-10788) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A54953) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-11-10 |