| NPI | 1144439639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 7469) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02002769A) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2017-04-24 |