NPI | 1871023556 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01083177A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 57712) |
Enumeration Date | 2017-06-15 |
Last Update Date | 2023-04-19 |