| NPI | 1255824512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02005737A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11020021A) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-10-11 |