| NPI | 1588004923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004882A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 2877) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2023-11-27 |