| NPI | 1093373987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02006923A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151013949) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2022-08-30 |