| NPI | 1578876785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01073536A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01073536A) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2020-10-13 |