| NPI | 1487067963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-9422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 3125) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2022-07-21 |