| NPI | 1356791537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 67576) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01079235A) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2023-07-28 |