| NPI | 1467715201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 11016758A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10061141) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2023-09-27 |