| NPI | 1407025497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01067732A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 46124) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2023-04-03 |