| NPI | 1104299593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005611A) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101022140) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2023-06-12 |