| NPI | 1184151490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 28892) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 63971) |
| 207Q00000X Family Medicine (Licence: AR E-14540) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2021-08-11 |