| NPI | 1609121847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01075178A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 05745) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2022-05-10 |