| NPI | 1932126653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C137279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD11595) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2024-03-22 |