| NPI | 1275616633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01040713) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01040713A) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2023-03-07 |