| NPI | 1487881439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101020823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02003753A) |
| 207Q00000X Family Medicine (Licence: AR E-7401) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2022-11-16 |