| NPI | 1316107881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 126832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01062354A) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2025-02-24 |