| NPI | 1548260680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01050865A) |
| Additional Taxonomies | 202K00000X (Licence: IN 01050865A) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-10-28 |