| NPI | 1184638868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02001804A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS10246) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-08-09 |