| NPI | 1982732202 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: GA 061916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A98608) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2024-04-30 |