| NPI | 1295715431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN IN02002130A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102208325) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2024-10-23 |