| NPI | 1265533855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.43393) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01052619A) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-06-16 |