NPI | 1215939954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01085774A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-05-3793) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2022-10-14 |