| NPI | 1447218797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 21550) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01078698A) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2025-03-28 |