| NPI | 1437315470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 48690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101244386) |
| 207Q00000X Family Medicine (Licence: VA 0116019100) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2022-08-29 |