| NPI | 1841289972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01068922A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35052435) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2023-11-20 |