| NPI | 1609913730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02002091A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 02002091A) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-11-20 |