NPI | 1083680805 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02006204A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS012432) |
207Q00000X Family Medicine (Licence: AZ 006906) | |
Enumeration Date | 2006-02-23 |
Last Update Date | 2020-11-24 |