| NPI | 1487638789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-22200) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01058871A) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2022-07-20 |