| NPI | 1548266307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01035748A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 053956) |
| 207Q00000X Family Medicine (Licence: FL 55024) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-08-03 |