| NPI | 1720422165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 305293) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01076378A) |
| 207Q00000X Family Medicine (Licence: IN 01076378A) | |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2018-03-17 |