| NPI | 1205281730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 01078942A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AL 49810) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2025-04-29 |