| NPI | 1487680005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01064877A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301085833) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2023-10-02 |