| NPI | 1538255823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 15697) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01037803) |
| 207Q00000X Family Medicine (Licence: IN 01037803A) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2017-01-17 |