| NPI | 1831779826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: AL DO.3518) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 103370) |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2026-02-20 |