| NPI | 1811968092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C-5042) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C 5042) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2018-07-09 |