| NPI | 1225473424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301507137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11017011A) |
| 207Q00000X Family Medicine (Licence: IA MD-43524) | |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2022-09-13 |