| NPI | 1508171810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01072129A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11015799A) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2021-11-13 |