| NPI | 1497925572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: IN 01067143A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 11013162A) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2019-04-01 |