NPI | 1407029499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301101909) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01069057A) |
Enumeration Date | 2008-04-10 |
Last Update Date | 2024-05-04 |