| NPI | 1013324193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 51467) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-13959) |
| 207Q00000X Family Medicine (Licence: MS 28114) | |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2024-03-08 |