| NPI | 1831333830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 29422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD.29422) |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2024-09-05 |