| NPI | 1295912558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02003276A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02003276A) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2018-04-20 |