| NPI | 1750368759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-3211) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000025923) |
| 207Q00000X Family Medicine (Licence: MS 24665) | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2017-02-28 |