| NPI | 1326057696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 48720) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01093026A) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-03-18 |