| NPI | 1306226451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD187823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018199A) |
| 207Q00000X Family Medicine (Licence: IN 01078960A) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2025-04-16 |