| NPI | 1447780259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102206925) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02006044A) |
| 207P00000X Emergency Medicine (Licence: VA 0102206925) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-01-13 |