| NPI | 1679954655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-15842) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02005361A) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-04-05 |