NPI | 1982263323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 88582) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11020581A) |
Enumeration Date | 2019-06-10 |
Last Update Date | 2022-10-04 |