| NPI | 1154371581 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02007492A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101014163) |
| 207P00000X Emergency Medicine (Licence: MI 5101014163DO) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2026-01-13 |