| NPI | 1558676429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2088P0231X (Licence: IN 01068641A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01068641A) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2022-06-01 |