| NPI | 1588624803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL me104344) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01055165a) |
| 207Q00000X Family Medicine (Licence: FL 104344) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2024-06-25 |