| NPI | 1184720765 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01028695) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01028695) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2011-05-18 |