NPI | 1457383416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01062020A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 30925) |
207Q00000X Family Medicine (Licence: TN 40954) | |
Enumeration Date | 2006-07-07 |
Last Update Date | 2016-01-06 |