| NPI | 1841731155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-15422) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2025-07-24 |