| NPI | 1528598513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01084577A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL40996) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2021-05-17 |