| NPI | 1255521092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: IN 01067774A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL10511) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: ND 11830) | |
| 207Q00000X Family Medicine (Licence: ND 11830) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2026-04-06 |