| NPI | 1467678987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0062608) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01-065721A) |
| 207Q00000X Family Medicine (Licence: KS 6430) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2022-10-18 |