| NPI | 1144212549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-9584) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01056364A) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2014-01-23 |