| NPI | 1518926419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01029300A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01029300) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2008-07-17 |