| NPI | 1841262714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02002518A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2915) |
| 207Q00000X Family Medicine (Licence: AR E-11967) | |
| 207Q00000X Family Medicine (Licence: OH 34.013713) | |
| 207Q00000X Family Medicine (Licence: GA 82824) | |
| 207Q00000X Family Medicine (Licence: CA 17462) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2019-09-10 |