NPI | 1174669246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME115384) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01062240A) |
207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME115384) | |
Enumeration Date | 2007-01-29 |
Last Update Date | 2024-07-16 |