| NPI | 1457516809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02003584A) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11014523A) | 
| Enumeration Date | 2008-07-25 | 
| Last Update Date | 2012-11-14 |