| NPI | 1518226828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004430A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP70002265) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2026-07-20 |