| NPI | 1356417125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01035705A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301049089) |
| 207Q00000X Family Medicine (Licence: CA A48825) | |
| Enumeration Date | 2006-11-25 |
| Last Update Date | 2024-05-11 |