| NPI | 1316175060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01070097A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 26410) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2023-11-27 |