| NPI | 1033405626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01082905A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-37304) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2020-10-14 |