| NPI | 1114183555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02003544A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11014487A) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2020-12-20 |