NPI | 1366883316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02006777A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 03909) |
Enumeration Date | 2013-07-07 |
Last Update Date | 2022-12-05 |