| NPI | 1427003573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-50400) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01046800) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2025-01-10 |