| NPI | 1891719324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101273522) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: VA 0101273522) |
| 207Q00000X Family Medicine (Licence: IN 01034573A) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-07-14 |