NPI | 1790764868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101012140) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02001246A) |
Enumeration Date | 2006-01-17 |
Last Update Date | 2024-02-22 |