| NPI | 1154584399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01075887A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 14002) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2022-05-19 |