| NPI | 1902872625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-15012) |
| Additional Taxonomies | 207ZH0000X Pathology Hematology (Licence: AK 4721) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-04-14 |