| NPI | 1669625869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0904X (Licence: IN 02003450A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02003450A) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2023-09-22 |