NPI | 1770859878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD222668) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01072999A) |
Enumeration Date | 2012-03-22 |
Last Update Date | 2025-07-28 |