| NPI | 1225027535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01030700A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 23450) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2021-04-27 |