| NPI | 1821052739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS7568) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02004743A) |
| 207Q00000X Family Medicine (Licence: NE 1419) | |
| 207Q00000X Family Medicine (Licence: IL 036.139269) | |
| 207Q00000X Family Medicine (Licence: MD H80598) | |
| 207Q00000X Family Medicine (Licence: LA 300622) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2024-04-03 |