| NPI | 1851400592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 63531) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01060179A) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-05-05 |