| NPI | 1902037336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD042176) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0077560) |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2024-11-26 |