| NPI | 1023370053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 571891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01072927A) |
| 207Q00000X Family Medicine (Licence: IN 11016632A) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-01-18 |