| NPI | 1417571209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01088147A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11020937A) |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2023-09-05 |