| NPI | 1902197726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01084472A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A123676) |
| 207Q00000X Family Medicine (Licence: AK 102782) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2023-09-01 |