| NPI | 1356782056 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: IN 02005192A) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02005192A) | 
| Enumeration Date | 2013-07-10 | 
| Last Update Date | 2019-02-05 |