| NPI | 1063894517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01080589A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018408A) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11018408) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-06-27 |