| NPI | 1184835852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01081622A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 6960695-1205) |
| 207Q00000X Family Medicine (Licence: WA MD60489032) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-11-27 |