| NPI | 1497149884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 57206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-11696) |
| 208D00000X General Practice (Licence: TN 57206) | |
| 208D00000X General Practice (Licence: AR E-11696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2021-03-11 |