| NPI | 1104265073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01079307A) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: MI 4301103662) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2023-10-02 |