| NPI | 1932272135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D37393) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101057583) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2024-05-15 |