| NPI | 1316515000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01093401A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11021899A) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2025-02-26 |