| NPI | 1134184781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01031210A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.151398) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-08-13 |