| NPI | 1942648118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A140710) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11016967A) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2022-07-21 |