| NPI | 1306263215 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IN 01077217A) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11017549A) | 
| Enumeration Date | 2014-03-28 | 
| Last Update Date | 2022-02-23 |