| NPI | 1629099387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 007784) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02001677A) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-09-12 |