| NPI | 1073007464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 02006080A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA DO-05823) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2026-08-11 |