NPI | 1972585131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01066617A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 23984) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2012-08-13 |