| NPI | 1093882409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 059507) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01055551A) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-03-24 |