| NPI | 1841291895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 049762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 49762) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2024-09-12 |