| NPI | 1891960233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-11149) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01067036A) |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2012-03-28 |