| NPI | 1598747677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01061802A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 22329) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2017-04-14 |