| NPI | 1063458255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 50601) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01044139A) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2014-10-15 |