| NPI | 1841368222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004236A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 50787021) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-11-30 |