| NPI | 1841589280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 89640) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01073491A) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2023-07-17 |