| NPI | 1922056969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: IN 01024876) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 65405) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-01-03 |