| NPI | 1598781288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02001799A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K7413) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-05-08 |