| NPI | 1275995219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01099563A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301117376) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2026-07-10 |