| NPI | 1821046558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C-4960) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR C4960) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-09-24 |