| NPI | 1821087172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2018015413) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01045516) |
| 207V00000X Obstetrics & Gynecology (Licence: IN 01045516A) | |
| 208M00000X Hospitalist (Licence: MO 2018015413) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2024-03-05 |