| NPI | 1609402544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01090085A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL84344) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2023-07-10 |