| NPI | 1598388167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01089859A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351046735) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2023-06-20 |