| NPI | 1497194609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01076381A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME138851) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2023-08-15 |