| NPI | 1427499318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01076754A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301103866) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301103866) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2020-09-28 |