| NPI | 1326200957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0054177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02003828A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11014445A) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-04-06 |