| NPI | 1194108670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01078683A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018128A) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-05-29 |