| NPI | 1346445277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01070158A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5315031940) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2020-11-18 |