NPI | 1184063331 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004819A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.063436) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2024-08-07 |